Nurse Case Manager

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve – we care.

What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you.

Job Summary

The Nurse Case Manager is an integral part of the Patient Services team, responsible for the coordination and delivery of services related to the patient support programs offered by McKesson Specialty. The role involves interactions with patients, insurance companies, pharmacies, physicians, and other health care professionals (HCPs) and provides support to their patients. The role involves understanding, adherence to corporate, divisional, departmental, and program-specific standard operating procedures.

This role is a full-time, permanent position with rotating evening shift (12pm-8pm) availability required.

Please note that the budgeted base salary for this position may exceed the posted range, reflecting our commitment to attracting top talent.

Specific Responsibilities

1. The Nurse Case Manager is the point of contact for the program, doctors, pharmacies, and other HCPs.
2. During the first 3-4 months of hire, NCM will be meeting key clinics for a face-to-face meet and greet to develop an ongoing relationship with the clinics.
3. May be required to provide training and educational materials to patients pertaining to their medication and conduct adherence follow-ups.
4. Review, analyze and validate information provided by patients and HCPs for accuracy and completeness to ensure initiation of services.
5. Follow the program protocols to ensure that the most appropriate next step is scheduled to ensure continuity of service delivery to HCPs and patients.
6. Complete follow-ups with patients on behalf of the physician offices, as required, to ensure adherence to treatment regimens.
7. Liaise with the patient, insurer, and physician regarding the documentation required for maximum reimbursement coverage, including the exploration of all public and private insurers and providing employer escalations as required.
8. Process data entry activities of pertinent information received at different points of contact during the delivery of program services.
9. Provide answers to general inquiry calls submitted via telephone, web-based platforms, or in person, on program services, disease state, or product-related questions, based on information provided as part of the program materials.
10. Provide HCP and Patients with a technical product overview when required.
11. Liaise with physicians' offices, services providers, and other parties to provide comprehensive and coordinated service to patients and physicians.
12. Receive, record, and report Adverse Events, as per program working instructions.
13. Maintain service levels in case management, including Adverse Events reported within twenty-four hours of receipt and any other Key Performance Indicators established at the Program level.
14. Perform data-entry, answer inbound calls, make outbound calls, manage e-mail and fax software, and general administrative functions including faxing, filing, and scanning.
15. Conduct reimbursement activities.
16. Other duties as assigned.

General Responsibilities

1. Adhere to professional standards as prescribed by the professional associations and McKesson as applicable.
2. Participate and assist in departmental continuous improvement activities related to process, quality, training.
3. Participate in the development of reports and tools for identifying signals that will flag misunderstanding, misconduct, fraud, or other out of protocol program participant-related incidents.
4. Assist with reviews of aggregate data to identify program trends and communicate these trends appropriately.
5. Maintain program data accuracy through review of program documentation for completeness and consistency.
6. Support patients and HCPs with training, education, and Injection services.
7. Act as lead point of contact between the program and stakeholders and works with clinics and client sales reps.

Competencies

Knowledge/Education

- Registered Nurse with current registration.
- Understanding and compliance with corporate, divisional, departmental, and program-specific standard operating procedures.

Experience

- 1-3 years experience in a previous job or jobs.
- Experience with Reimbursement Navigation.
- Demonstrated ability to communicate efficiently and in an empathetic manner over the phone and in person.
- Experience in the healthcare industry including, but not limited to medical claims, insurance verification, pharmacy, and/or pharmaceutical manufacturers is preferable.

Computer/Application Skills

- Required to use menu-driven retrieval and search functions on Windows-based applications, web-based applications, and proprietary information technology systems; ability to use switch-based telephony software, etc.

Problem Solving

- Navigates quickly and effectively to resolve problems and obstacles, even when complex and unique circumstances occur; responds to recurring problems by investigating the underlying causes and taking steps to eliminate them. Only difficult problems are referred to supervisor.
- Dermatology experience is a plus.

External Customer Service

- Excellent customer service skills in dealing with patients, physicians, and other clients.
- Resolve customer complaints.

Planning/Coordinating Work

- Required to initiate planning and coordination of activities with other members in the work group, make appropriate adjustments to one's own work plans.

Innovation/Proactivity

- Expected to suggest innovations to the supervisor, which affect the job or its workflow. Tries different approaches when initial efforts to solve problems fail; anticipates possible problems and develops alternatives.

Working Conditions

- Able to work independently and make appropriate decisions.
- May be required to rotate shifts.

Language Skills

- Bilingual - ability to communicate written and verbally in both English and French is desired and preferred.

Travel

- Up to 10% of travel may be required.
- Valid driver's license required.
- Ability to apply for corporate credit card for travel expenses.

We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience, skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here.

Our Base Pay Range for this position: $49,800 - $83,000

McKesson is an Equal Opportunity Employer

McKesson provides equal employment opportunities to applicants and employees and is committed to a diverse and inclusive environment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, or genetic information. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.

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